One of the biggest issues related to long term care is stable funding. Several studies have shown that the only way to guarantee quality long term care is to establish a more stable funding base using Medicare as the primary source of funds. However, today’s funding structure for skilled nursing home facilities relies primarily on Medicaid, not Medicare, as its primary source of income. This deviation has had severe consequences as a recent study that was released in October 2007 illustrated that Medicaid’s reimbursement programs are significantly underfunded and getting worse with each year. This underfunding has created several problems that must be addressed in the upcoming fiscal years.

The Medicaid Underfunding Problem

It is estimated that Medicaid’s underfunding problem is currently about $13.15 per patient per day. While this may not seem like a lot of money, when it is compounded by the number of Medicaid recipients in skilled nursing home facilities across the country, the underfunding problem is valued at about $4.4 billion.

This underfunding situation creates several problems. First of all nursing home facilities are operating on skeleton staffs and cutting costs in order to stay open because of their underfunding problems. This means that meeting minimum care standards is difficult for many facilities, not because they don’t care about their patients, but because they simply don’t have the funds to do so. The second problem that Medicaid underfunding has caused is an added work load for Medicare. The costs that are not absorbed by Medicaid are often passed on to Medicare. This is hurting Medicare’s ability to stay afloat as it drains many resources from the main program that were not originally tagged for nursing home care.

The Extent of the Problem

While the underfunding problem is nationwide, there are a few states that are being hit harder than others. The average underfunding rate for Medicaid is about $13.15 per patient per day, however, in states like Illinois, New Jersey, Wisconsin, Minnesota, Utah, New Hampshire, Missouri, Delaware, Washington and Massachusetts, have even larger undrefunding rates. This means that low income seniors and people with disabilities in these states are being forced to work with skilled nursing home facilities that simply do not have the resources needed to provide the level of quality care that people in other states are receiving.

What You Can Do

In order to solve this problem we all need to talk with Congress to improve the funding structure for both Medicaid and Medicare programs. This system is obviously not working efficiently as it is currently structured so we all need to work together to find a funding formula that is a better fit for the current demand for quality skilled nursing home care.

Your long term care needs are going to be based on your medical history and your current health. To make sure that you are not a victim of Medicaid or Medicare underfunding you need to educate yourself about long term care and long term care health insurance.